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Brain injury - hospital discharge & return home

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Brain injury - hospital discharge & return home

The return home from hospital after a brain injury is usually eagerly awaited by family members. Here are some handy tips for making it a smooth transition. 

The degree of changes a family may have to make will depend on the degree of brain injury. For example, in the case of a severe  traumatic brain injury, the family may be taking on a full time caring role and need a wide range of supports. With a mild brain injury, a nearly complete recovery may be expected but the family may need to assist the person with ongoing rehabilitation at home for behavioural issues and cognitive changes such as memory problems. 


Hospital discharge information

Upon discharge, the hospital should provide you with a wide range of information on topics such as:

  • Prescriptions and medications
  • Cognitive changes and how to respond appropriately
  • Symptoms of any complications that could need urgent treatment
  • Activities to avoid and for how long (e.g. work, driving, drinking alcohol)


If you have not received this information, contact the hospital. Often the social worker will be able to help best with obtaining this information. 


The first few days after discharge

  • Ensure someone stays with the person for the first two days
  • Make sure you can easily contact emergency services if needed
  • Don't drink any alcohol. 
  • Rest as much as possible and don't rush into activities. 


Important symptoms to watch out for

Learn as much as you can about brain disorders such as traumatic brain injury. There are various symptoms that are very normal after a brain injury such as headaches, inability to concentrate, fatigue, depression, memory problems and poor sleep. These generally do not require medical treatment but if you have any concerns consult your doctor. 


However there are symptoms that could indicate urgent treatment is needed. Examples of these include:

  • Any unconscious episodes or fits
  • Vomiting
  • Increased disorientation or loss of balance
  • Loss of hearing in one or both ears
  • Changes in vision
  • Sudden difficulty understanding or speaking
  • Paralysis or weakness in the limbs
  • Bleeding from the ears, or clear fluid from ears or nose
  • Severe headaches not relieved by paracetamol. 


 Ongoing rehabilitation

The family plays a key role in ongoing rehabilitation after hospital discharge and any formal period of rehabilitation are over. If the rehabilitation team has not provided any information on how the family can help in the long term, contact them for this information. 


In some cases, a person returns home after a brain injury and has unrealistic expectations about how soon they can return to activities such as work and driving, if at all. The family may need to help the person slowly come to terms with their abilities and how long recovery may take, especially if self-awareness has been affected (see our Self-awareness fact sheet). 


Fatigue is an extremely common problem after a brain injury, and it's common to experience several days of extreme fatigue simply by overdoing activities. Family members often need to monitor how much a person is doing in order to avoid fatigue, and ensure regular rest breaks are taken. Providing a structured daily routine will greatly reduce stress for the person with the brain injury and help them manage their low energy reserves. 


Challenging behaviours such can emerge after the return home due to various cognitive changes. These can be very difficult for the family but having consistent appropriate responses to these behaviours can make a significant difference. Most rehabilitation specialists recommend avoiding alcohol for at least two years, if not permanently, after a significant brain injury. See our introduction to challenging behaviours fact sheet. 


Support for family members

Family members may have to take on new roles and responsibilities. For example, a person may now have to take on the role of bread winner or full time parenting for the first time. Children may find they need to help out around the house more. It is important to obtain as much support for the family as possible to ensure your own health in the long-term and provide consistent support. Contact your Brain Injury Association for all the available supports in your area. 


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